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Impact of subspecialty training on management of laryngopharyngeal reflux: results of a worldwide survey

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

To study the management of laryngopharyngeal reflux (LPR) among the subspecialties of practicing otolaryngology-head and neck surgeons and their trainees.

Methods

A survey was sent to over 8000 otolaryngologists (OTOHNS) over 65 countries, utilizing membership lists of participating otolaryngological societies. The outcomes were answers to questions regarding LPR knowledge and practice patterns, and included queries about its definition, prevalence, clinical presentation, diagnosis, and treatment.

Results

Of the 824 respondents, 658 practiced in one specific otolaryngologic subspecialty. The symptoms and findings thought to be the most related to LPR varied significantly between subspecialists. Extra-laryngeal findings were considered less by laryngologists while more experienced OTOHNS did not often consider digestive complaints. Compared with colleagues, otologists, rhinologists and laryngologists were less aware of the involvement of LPR in otological, rhinological and laryngological disorders, respectively. Irrespective of subspecialty, OTOHNS consider symptoms and signs and a positive response to empirical therapeutic trial to establish a LPR diagnosis. Awareness regarding the usefulness of impedance pH-studies is low in all groups. The therapeutic approach significantly varies between groups, although all were in agreement for the treatment duration. The management of non-responder patients demonstrated significant differences among laryngologists who performed additional examinations. The majority of participants (37.1%) admitted to being less than knowledgeable about LPR management.

Conclusions

LPR knowledge and management vary significantly across otolaryngology subspecialties. International guidelines on LPR management appear necessary to improve knowledge and management of LPR across all subspecialties of otolaryngology.

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Acknowledgements

The YO-IFOS Staff and all persons that had spread the survey. All scientific societies that contributed to spread the survey.

Funding

None.

Author information

Author notes

  1. Lee M. Akst and Jonathan M. Bock have equally contributed to the paper’s supervision and should be considered as co-last senior authors. Jerome R. Lechien and Thomas L. Carroll are listed as co-first author of the study.

Authors and Affiliations

  1. Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France

    Jerome R. Lechien, Tareck Ayad, Necati Enver, Young-Gyu Eun, Carlos M. Chiesa-Estomba, Sven Saussez, Petros D. Karkos & Lee M. Akst

  2. Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium

    Jerome R. Lechien & Sven Saussez

  3. Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, University Libre de Bruxelles, Brussels, Belgium

    Jerome R. Lechien & Sven Saussez

  4. Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France

    Jerome R. Lechien

  5. Division of Otolaryngology, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Thomas L. Carroll

  6. Department of Surgery, University of Auckland, Grafton, Auckland, New Zealand

    Jacqueline E. Allen

  7. Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada

    Tareck Ayad

  8. Department of Otolaryngology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey

    Necati Enver

  9. Department of Otorhinolaryngology and Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea

    Young-Gyu Eun

  10. Department of Otolaryngology, School of Medicine, São Paulo Federal University, Sao Paulo, Brazil

    Paulo S. Perazzo

  11. Department of Otolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo, Sao Paulo, Brazil

    Fabio Pupo Ceccon

  12. Disciplina de Otorrinolaringologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil

    Geraldo D. Sant’Anna

  13. Department of Otorhinolaryngology, Clinical Hospital, University of São Paulo School of Medicine, Sao Paulo, Brazil

    Rui Imamura

  14. Department of Otology, Neurotology and Skullbase Surgery, Madras ENT Research Foundation, Chennai, India

    Sampath Kumar Raghunandhan

  15. Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain

    Carlos M. Chiesa-Estomba

  16. Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain

    Christian Calvo-Henriquez

  17. Department of Otorhinolaryngology and Head and Neck Surgery, Thessaloniki Medical School, Thessaloniki, Greece

    Petros D. Karkos

  18. Department of Otolaryngology, Centre Hospitalier du Luxembourg, Luxembourg, Luxembourg

    Marc Remacle

  19. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Lee M. Akst

  20. Division of Laryngology and the Professional Voice Department of Otolaryngology, Communication Science Medical College of Wisconsin, Milwaukee, WI, USA

    Jonathan M. Bock

  21. Laboratory of Anatomy and Cell Biology, Faculty of Medicine, University of Mons (UMONS), Avenue du Champ de Mars, 6, 7000, Mons, Belgium

    Jerome R. Lechien

Authors
  1. Jerome R. Lechien
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  2. Thomas L. Carroll
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  3. Jacqueline E. Allen
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  9. Geraldo D. Sant’Anna
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  10. Rui Imamura
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  11. Sampath Kumar Raghunandhan
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  12. Carlos M. Chiesa-Estomba
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  13. Christian Calvo-Henriquez
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  14. Sven Saussez
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  15. Petros D. Karkos
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  16. Marc Remacle
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  17. Lee M. Akst
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  18. Jonathan M. Bock
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Corresponding author

Correspondence to Jerome R. Lechien.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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IRB approved the study protocol (CHUB2020-12).

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Lechien, J.R., Carroll, T.L., Allen, J.E. et al. Impact of subspecialty training on management of laryngopharyngeal reflux: results of a worldwide survey. Eur Arch Otorhinolaryngol 278, 1933–1943 (2021). https://doi.org/10.1007/s00405-021-06710-y

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  • DOI: https://doi.org/10.1007/s00405-021-06710-y

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